PROJECT SUMMARY The problems with current surgical training paradigms include the failure of opportunities for training to keep up with rising demands; surgeons in practice often have limited time and resources to practice, leading to risky usage of more complex technologies. Successful utilization of virtual reality (VR) in surgical training has led to the wide-spread adoption of such systems in General Surgery training programs; however, the focus on high-fidelity, near-real-life environments has made the methodology prohibitively expensive and inaccessible. This resource intensiveness has resulted in generalized VR modules that do not target specific procedures or skills. Considering the increasing number of new and complex devices coming onto the market and the direct link between volume of procedures and surgical expertise, the healthcare field must see a radical shift in the use of surgeon training technology in order to maximize quality training time before trainees enter the workforce. The current state of VR is ill-fit to be a true surgical training supplement as it cannot fulfil this need. Osso VR is developing a solution to this issue: The Smart Curriculum, a purposefully low-fidelity VR-based training curriculum that incorporates an artificial intelligence (AI) to adapt the session and curriculum to a trainee?s performance. A low-fidelity approach has been shown in pilot studies to have equal transfer rates compared to high-fidelity while being much less resource-intensive, thus making it ideal for broadening the accessibility of VR. An AI to customize a procedure to a surgeon?s performance and background will provide targeted practice to hone procedure familiarity and surgical skill. Thus, the combination of VR and AI will show increased transfer rates compared to classic VR paradigms at a fraction of the cost. Practicing surgical techniques on-demand with direct quantitative feedback plays an essential part in developing the needed expertise to a) improve the quality of the outcomes for patients and b) improve efficiency in the surgical technique thereby reducing the operating time. The work proposed in this Phase I project will focus on developing a proof-of-concept AI-incorporated module for the treatment of hip fractures with a cephalomedullary fixation device as a proof-of-concept. The proposed system will allow orthopedic surgeons to enhance their training in a virtual environment and predict the outcome of interventional decisions before actual surgery without any risks to the patients. The work plan for this Phase I SBIR project will be accomplished by first establishing all key subject matter and technical needs for the cephalomedullary fixation procedure to determine key learning milestones for a pilot procedure; second, we will determine the parameters for and wireframe the AI; finally, we will build necessary technical components for the prototype training module to validate the pilot procedure. Osso VR is the current leader in the field, and the addition of an AI component to individualize each surgeon?s training experience will be invaluable to revolutionizing the surgical training paradigm.